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E 631 

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U. S SANITARY COMMISSION. 

lyj-o. 23. 



WASHiNcrrox, July 31st, 1861. 

The Committee appointed on tlie 29tli inst., to visit tlie Mili- 
taiy General Hospitals in and around Washington, and to 
ascertain tlicir condition and the wants of the sick and wounded 
volunteers, beg to report, that they have visited the following 
Hospitals, viz. : 

1. The WasJdnytoii Injivnianjy (J stred • 

2. The Union Hotel Hospital, Georgetown ; 

3. The •Seminary Hospital, Georgetoicn / 

4. The CoUmibia College Hospital ; 

5. The Alexandria Hospital. 

With the exception of the first named Institution, all of these 
Plospitals have been hired by the Government and converted 
to their present uses, furnished and provided witli ofiicers and 
attendants, within the present month. There is also a Hospital 
on E street, and another at Annapolis, Maryland, which 3^our 
Committee were unable to visit, and also a Hospital for erup- 
tive and contagions diseases. 

The aggregate number of patients in these Hospitals is 
about 900 ; of whom about 450 are men wounded in the affair 
of the 2ist inst., the remainder comprising medical cases, and 
those sick in Hospital before the engagement. 

The Committee takes pleasure in reporting, in general terms, 
that the Hospital accommodations in this locality, and at the 
])resent time, are extensive, that their officers and attendants 



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are e(|iuil to tlioir duties, and that the sick and Avonnded are 
generally doing wrll. Certain facts which have been observed, 
and snofirestions which have occurred to thcni, will be stated in 
connection with each Ilosjiital, in the order in which it was 
visited. 

1. Infirmary^ C Street. — This building has been in Tise for a 
number of years. It is said to be capable of accommodating 
180 patients, and at present contains about ICO. A number of 
Sisters of Charity are attached to the Institution, sufficient to 
attend to the preparation and distribution of food to the sick. 
The building is defective in many of the particulars deemed 
essential in the construction of a perfect Hospital at the present 
day. The ceilings are low ; the windows small, and too few in 
number ; the supply of water and acconnno<lations for bathing, 
and the provision of water-closets arc insufficient ; and there is 
no dead house — dead bodies being kept in a lower room within 
the building until they are buried. The basement is damp — its 
ceilings low, its wards small, and badly ventilated. Commend- 
able foresight has been exercised in electing tents suitable for 
the reception of cases of Fever and Erysipelas on a vacant space 
in the rear building. The surface of this space, however, is 
very uneven and imperfectly drained. 

2. The Union Hotel llosjyital, Geor^getoivn, was occupied 
as its name implies, until recently hired fur its present use. It 
is considered capable of accommodating 225 patients, and at 
present contains 189. It is well situated, but the building is 
old, out of repair, and cut up into a ni mber of small rooms, 
with windows too small and few in number to afford good ventila 
tion. Its halls and passages, are narrow, tortuous, and abrupt, 
and in many instances with carpets still unremoved from their 



Ci^noors, and walls covered with paper. There are no provisions 

■^ for bathing, the water-closets and sinks are insufficient and 

^' defective, and there is no dead-house. The wards are many of 

them overcrowded, and destitute of arrangements for artificial 

ventilation. The cellars and area are damp and undrained, 

and much of the wood work is actively decaying. 

3. The Seminary Hospital, in the immediate vicinity of the 
last, is much better adapted to Hospital purposes, though it 
also is defective in water-closets and baths, and its passages and 
halls are tortuous and narrow, and many of its wards are small, 
and imperfectly ventilated. There are no arrangements for 
artificial ventilation, and the number of beds would greatl}- 
overcrowd the wards if all were occupied. At the present 
time, when the warmth justifies the universal opening of win- 
dows and doors, the risk of communicable disease is lessened, 
but during the autumnal changes the absence of facilities for 
artificial ventilation will be productive of serious disease. Its 
wards at present contain about 135 patients, though beds are 
spread for 30 more. 

4. The ColumVia College Hospital^ situate upon the highest 
ground in the immediate vicinity of Washington, was recently 
used for academic purposes, and is an old building in a state 
of pretty good repair. It is a large four-story structure, in the 
form of a parallelogram, and said to be capable of containing 
250 beds, when crowded. It has now 230 patients, with several 
hospital tents erected upon the level ground in the rear. Each 
story is bisected longitudin^illy by a narrow hall, with terminal 
windows, and flanked right and left by small wards. Opening 
upon each of these wards, by narrow doorways, are two slips 
or smaller rooms, barely large enough to contain a single bed 



and chair, and totally unfit for dormitories for the sick. This 
peculiarity in the architecture makes ventilation exceedingly 
difficult, and the present absence of disease originating in im- 
pure air is due to open doors and windows, and the newness of 
bedding and furniture, and to the fact that the walls and wood 
work are not yet saturated by animal emanations. The removal 
of some of the partition walls would be unexpeosive, and in the 
highest deo:ree desirable. 

No dead-house has been provided, and the hospital tents in- 
tended for communicable diseases, such as erysipelas and 
typhoid fever, should be further removed. There is a total 
want of water-closets, and the use of close stools, and consequent 
necessity of conveying the latter, by hand, through the halls, 
induces constant impurity of the air, and the risk of communi- 
cating such diseases as typhoid fever and dysentery. Bath 
tubs have been provided, but not running water, and the incon- 
venience attending upon general ablutions makes them in 
man}^ cases impossible. 

5. The Alexandria Hospital is also an old building, form- 
erly occupied as a Seminary. It is an irregular structure, and 
badly adapted to hospital purposes. Its halls and stairways are 
narrow and abrupt, and many of its wards small and difficult 
of access. Its immediate precincts are damp from the proximity 
of large shade trees, and the wood-work of its piazzas and 
sheds is rapidly decaying. Yentilat.ion is even now very defect- 
ive, and an unhealthy odor pervades the building. The latter 
is due in a measure to the fact, that troops recently quartered 
in the buildins:, had been allowed to accumulate filth in. some 
of the upper rooms and the cellar. It should be stated, that 
the physician in charge, has used every endeavor to cleanse the 
premises, and is exercising admirable intelligence and vigor 



in compensating for many of its architectural defects. There 
beins: no indoor water-closets or baths, the same necessity for 
conveying close-stools through the house induces the risk that 
obtains in the Union Hotel and other Hospitals. Evidences 
were exhibited in some cases of the prevalence of retained air 
poison, and when the windows and doors are closed during 
stormy or cooler weather, it is feared disease will be engendered. 

There is no dead house. This Hospital now contains ninety- 
six patients, with an estimated capacity for 150. 

For present demands, the Hospitals indicated possess some 
advantages, but should not be deemed models, or as furnishing 
precedents for the use of similar buildings in the future. Old 
buildings do not make good Hospitals. It is also fixed in the 
experience of those most able to judge, that large buildings are 
liable to grave objections. They form store- houses for morbid 
emanations, and are only comparatively safe when ventilated at 
great expense, by complicated artificial means. The scaly 
walls and cracked wood-work of old buildings present innum- 
erable lurking places for foul air, and patients occupying such 
buildings are too frequently attacked by erysipelas, or scourged 
by Hospital gangrene. Even when such maladies are absent, the 
almost constant presence of animal impurities imposes a weight 
upon the recuperative energies of the sick, which by inducing 
debilitating complications retards or prevents their recovery. 

We must remember, in criticizing these institutions, the cir- 
cumstances under which they were selected, and the additional 
fact, that Washington does not offer many buildings suitable 
for Hospital purposes. Your Committee sees in these build- 
ings a confirmation, if any were needed, of their belief, that 
wooden pavilions properly constructed and scattered, constitute 
the best Hospital structures. Upon the ground of economy, 
also, they would be preferable. We cannot deny ourselves the 



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pleasure of alluding in terms of well cai-ned praise, to the 
medical men in charge. The difficulties encountered by them 
in quickly converting old and badly constructed buildings into 
Hospitals, in cleansing and furnishing them, and providing the 
necessary attendance and service, cannot be adequatel}'' set 
forth in the compass of a brief report. The results of tlieir 
labors, constantly appearing, have evoked our surprise and ad- 
miration. The moral aspect of the wards is excellent, the sick 
being generally cheerful and contented, and there is every 
indication that the proper relationship exists between the doc- 
tor and his patient. Kindness seems to be everywhere prevalent 
and the nursing is generally admirable. 

We come now to consider the condition and wants of the 
patients in the General Hospitals. Of these, nearly one-half had 
accumulated from the regiments stationed in and around Wash- 
ington, many having been sent to Hospital when the advance 
took place previous to the battle of the 21st July. They com- 
prised mainly, medical cases — diarrhoea, dysentery, miasmatic 
and typhoid fever ; the surgical cases consisted of accidental 
wounds, and patients with varicose ulcers, and rupture, and 
also men suffering from phthisis, and other diseases with which 
they were allowed to enter the military service in consequence 
of imperfect inspection. This number was increased by the 
wounded from the action of the 18th July, but the great inHux 
of wounded commenced on the night of the 21st July, and con- 
tinued through the three or four following days. The total 
number of wounded and disabled men and officers wlio found 
their way into the General Hospitals in Georgetown, Washing- 
ington, and Alexandria during the week following the battle at 
Bull Run was not lar from 500. 

They consisted mainly of those who were least severely injured 
in that battle ; all of the fatally and severely wouuded men 



Laving been left of necessity, as it would seem, upon the field. 
The great majority of the soldiers wounded on the 21st July, 
wlio were seen by your committee in the several Hospitals, had 
reached them mainly through their own individual exertions, 
most of them having marched from the field of battle to their 
camps on the Potomac. Tliere were many instances of men 
with bullet wounds through their legs and thighs, who walked 
over twenty miles during the twenty-four hours after they were 
wounded ; and in one case, a poor fellow whose arm had been 
an)putated above the elbow, on the field, reached a Hospital in 
Washington on tlie day afterwards in safety, having w^alked 
the whole distance. It is much to be regretted that he has 
since died from erysipelas in the Hospital on E. street. As a 
general rule, the Avounds of these men were doing well. From 
the camps many were brought to the Hospitals in w^agons and 
ambulances, but yonr Committee were unable to find an in- 
stance in which a wounded man was thus conveyed from the 
field of battle to a Hospital. 

A very large proportion of the wounds were caused by 
bullets, and these not of the minie variety; some by grape shot 
and fragments of shells ; there were a very few bayonet wounds, 
and but a solitary case of sabre cut. The temper and feeling 
of the wounded men was good ; many of tliera were hopeful 
and buoyant, a few sad and depressed, but the general tone 
M-as that of men who felt that they had done their duty, and 
were ready to do it again. In some instances expressions of 
disrespect and blame towards their officers were volunteered in 
answer to inquiries as to how. and when they received their 
M'ounds. In the opinion of your Committee the medical and 
surgical treatment extended to the sick and wounded in the 
Hospitals, is in the main excellent, and the supply of surgeons 
ample. The medical students supplied for the emergency 



from Isew York, as surgical dressers, with a few excep- 
tions, proved very iiseful to tlic surgeons, and were doing 
excellent service. Tiie female nurses, also, as ftir as your Com- 
mittee could ascertain, were of great comfort to the sick. They 
were tolerated without complaint, and, in several instances, 
their services were even highly spoken of by tlie medical offi- 
cers in chai'ge. In regard to male nurses, on the conti'ary, 
there was much complaint as to their inefficiency and want of 
aptitude and disposition for their duties; this was especially 
remarked of the volunteers."'^ 

The su2')ply of food, hospital stores, and medicines was ample 
and excellent, with the exceptions hereafter to he mentioned, 
but the Hospital Fund, the usual source of supply of extras in 
the way of comfort and luxury to the sick, in Military Hospi- 
tals, was entirely deficient in most of the Hospitals. The ab- 
sence of this fund, which accumulates from the sale of the 
excess of the supply of food from the Commissary department 
over the amount actually consumed by the sick, and which is 
usually amply sufficient for the provision of all extras required 
in the w\iy of chickens, milk, fresh eggs, porter, &c., &c., is 
explained by the recent organization of the several Hospitals, 
sufficient time not having yet elapsed for its accumulation, and 
also by the fact that the sick have required a larger proportion 
of their rations than usual, in consequence of their exhausted 
and depressed condition on admission, and the tendency, 
already observed in their ailments, to assume an adynamic or 
typhoid character. Your Committee were enabled to meet this 
difficulty in some degree, and very acceptably, by supplying 



* The Commission has already supplied ouc pvofession.'il male nurse, who is 
doing very acceptable service in the Georgetown Seminary Hospital, and it is 
probable that others will be required. 



ice to the several ITospitals, from the stores of the Commission, 
this article being in much demand for the sick, and only ob- 
tainable by means of the Hospital Fund. Two articles of 
medicine not on the U. S. medical supply table — Delphinium, 
used for killing vermin, and Sol. of Persulphate of iron, for 
restraining bleeding, were asked for, and have been supplied 
by the Commission. 

But the principal want experienced by the sick, and one 
which tlie Government makes no provision whatever for meet- 
ing, was found by your Committee to be clean and appro- 
priate Hospital clothing. But for the liberal forethought of the 
benevolent women of the nation, onr soldiers would have been 
compelled to lie sick and wounded in the clothes in which they 
entered the Hospital wards, and which, in many cases, had not 
been changed or even washed for weeks before. Many had 
been already supplied, and your Committee had the satisftic- 
tion of seeing, within a very few days after their first visit to 
the Hospitals, that every sick man in Hospital was fully pro- 
vidoi] witli a i^roper suit of clothing, by the authority of the 
Commission. 

ISTo available provision being made by Government foi- the 
washing of the clothing worn by volunteers on their entering 
Hospital, the Connnittee secured the authority of the Cop.imis- 
sion for the employment of laundresses for this jiuipose ; so 
that when the soldier is ready to leave Hospital and resume his 
duties, his clotliing v;ill be clean and fit for use. 

The services of a barber were also authorized to be procured 
for the sick, and your Committee can bear witness that he con- 
tributed not a little to their cleanliness and comfort. AVire 
frames, for the protection of wounded limbs from the ju-essure 
of bed-clothes, were found to be wanted, and they were sup- 
plied. Water-beds, of India rubber, drinking cups, with 



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spouts, for adininistering food and medicine, splints, bandages, 
and lint have also been furnished. Bed-tables, with writing 
paper and franked envelopes have alj^o been obtained, and it is 
proposed to add easy chairs, games, and other articles for the 
comfort and amusement of convalescents, as they seem to be 
desirable. 

Another subject was recognized by your Committee as pos- 
sessing much interest and importance, viz. : the provision of 
systematic and reliable means of identifying the remains of 
soldiers dying in the General Hospitals, and of properly mark- 
ing tiie graves in which they are interred, so that the reason- 
able inquiries of friends and relations may be proi)erly an- 
swered. This iiuitter was brought before the Commission, 
and referred to a Special Committee, for immediate action. 

In conclusion, and as the result of their observations, your 
Committee cannot refrain from expressing the opinion that, 
although they have spoken favorably as to the provisit.)ns for 
the accommodation of the sick, and their general good condition 
in and around AVashington at the present time, if the result of 
the advance of the 21st of July had been more favorable to the 
national arms, if our troops had occupied the field of battle, and 
if a larger proportion of our wouiulod had been consequently 
brought by ambulances to the hospitals, together with the 
wounded of the enemy, the Hospital accouimcdations and sup- 
plies would not have been sufticiently ample to have met their 
wants, and the expectations of the nation. A\^e would sug- 
gest that Government cannot err in making the most liberal 
provision for the sick and wounded, and in the promptest 
manner, by the accumulation of large stores of bedding and 
hospital supplies at safe and available localities near the main 
body of the army. It is a just estimate to assume the ueces- 
sitv of providing for ten per cent, at least of sick fur an army 



11 



iu the field; and tliis would bring the number nearer 15,o00 
than 1,500, whilst with hard fought battles in prospect, and 
the sickness of the autumn months, the percentage to be 
provided for will probably be much higher than this estimate. 

Your Committee venture to embody their concluBions in the 
form of suggestions, and would submit to the Commission 
(2dly) the propriety of rccosn mending to Government that here- 
after instead of hiring old buildings for General Hospitals they 
should order the erection of a sufficient number of wooden 
shanties or pavilions of appropriate construction, and fully 
provided with water for bathing, washing, and water-closets, 
and ample arrangements for ventilation and for securing warmth 
in winter, to accommodate from thirty to sixty each, and to be 
sufficiently distant not to poison each other. This suggestion 
embodies the latest and best views as to the construction of hos- 
pitals, and its adoption would save both lives and money. 

3d. If the funds of the commission allow, one or moi'e prac- 
ticed male nurses, selected from the civil hospitals of the 
country, should be secured for each of the military general hos- 
pitals, Hov especial attendance upon the more serious surgical 
€ases. 

4tli. In view of the inevitable accumulation of chronic cases 
of disease in the general hospitals near the seat of war in large 
numbers, and of the great advantages that would be secured to 
many of them b}- change to a northern climate with sea-air, 
and for many other equally important considerations, 3'our 
cojnniittee would suggest that the recommendation already 
made by the Commission as to the establishment of a general 
military hospital in the harbor of New York, be again urged 
upon the attention of the War Department. 



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013 744 362 4 • 



otli. It' the pi'estiit liosjMtiils arc to Lc occupied (lui-ii)g tlie 
liill n))(l Aviiiter montlis, some jdan slioiild Le at once adopted 
and applied, b}' the competent antlioritics, to correct their archi- 
tectural defects, to provide facilities for bathing and water- 
closets, to introduce water on each floor, and to separate the 
dead-houses from the wards occupied bv the sick. Measures 
should also be taken to improve their ventilation, and for their 
thorough warming in winter. Your Committee recommend the 
Commission to bring these subjects to the notice of the proper 
authorities. 

All of which is re>})Ootfnlly submitted. 

WAl. IJ. VAN liUliEN, M.D., 
C. li. AGXEAV, MA). 



The above report was accepted and adopted by the Commis- 
sion on the ?>lst July, 1861. 

VllE}). LAAV ()LM8'iKl), 

liesident Seeretai'v. 



A 



LIBRARY OF CONGRESS 




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